Department of Medical Physics, University of Wisconsin, Madison, WI, USA.
Siemens Healthineers, Erlangen, Germany.
Med Phys. 2018 Oct;45(10):4510-4518. doi: 10.1002/mp.13120. Epub 2018 Sep 6.
Four-dimensional (4D) DSA reconstruction provides three-dimensional (3D) time-resolved visualization of contrast bolus passage through arterial vasculature in the interventional setting. The purpose of this study was to evaluate the feasibility of using these data in measuring blood velocity and flow.
The pulsatile signals in the time concentration curves (TCCs) measured at different points along a vessel are markers of the movement of a contrast bolus and thus of blood flow. When combined with the spatial content, that is, geometry of the vasculature, this information then provides the data required to determine blood velocity. A Fourier-based algorithm was used to identify and follow the pulsatility signal. A Side Band Ratio (SBR) metric was used to reduce uncertainty in identifying the pulsatility in regions where the signal was weak. We tested this method using 4D-DSA reconstructions from vascular phantoms as well as from human studies.
In five studies using 3D printed patient-specific cerebrovascular phantoms, velocities calculated from the 4D-DSAs were found to be within 10% of velocities measured with a flow meter. Calculated velocity and flow values from three human studies were within the range of those reported in the literature.
4D-DSA provides temporal and spatial information about blood flow and vascular geometry. This information is obtained using conventional rotational angiographic systems. In this small feasibility study, these data allowed calculations of velocity values that correlated well with measured values. The availability of velocity and blood flow information in the interventional setting would support a more quantitative approach to diagnosis, treatment planning and post-treatment evaluations of a variety of cerebrovascular diseases.
四维(4D)数字减影血管造影(DSA)重建可在介入环境中提供对比剂团通过动脉血管的三维(3D)时变可视化。本研究旨在评估使用这些数据测量血流速度和流量的可行性。
在血管内不同位置测量的时间浓度曲线(TCC)中的脉动信号是对比剂团移动的标志,也是血流的标志。当与空间内容(即血管的几何形状)结合使用时,这些信息提供了确定血流速度所需的数据。基于傅里叶的算法用于识别和跟踪脉动信号。使用旁带比(SBR)度量来减少在信号较弱的区域中识别脉动的不确定性。我们使用血管体模和人体研究的 4D-DSA 重建来测试这种方法。
在使用 3D 打印的患者特定脑血管体模进行的五项研究中,从 4D-DSA 计算得出的速度与流速计测量的速度相差 10%以内。三项人体研究中的计算速度和流量值在文献报道的范围内。
4D-DSA 提供了关于血流和血管几何形状的时间和空间信息。这些信息是使用传统的旋转血管造影系统获得的。在这项小型可行性研究中,这些数据允许计算出与实测值相关性良好的速度值。在介入环境中提供速度和血流信息将支持对各种脑血管疾病进行更定量的诊断、治疗计划和治疗后评估。